Comparison of the effectiveness of various methods of surgical treatment of male urethral stricture

Background. Urethral strictures are a common urological disease characterized by narrowing of the lumen of the urethra, accompanied by a slower outflow of urine, pain in the perineum and lower back, possible dysfunction of sexual function, and the presence of micro- and macrohematuria. Urethroplasty (single-stage and stage-by-stage) using autologous grafts of buccal epithelium or part of the penis (dorsal part or skin flap) remains the “gold” standard in the treatment of urethral strictures (US). Despite the fact that considerable experience in urethroplasty has recently been accumulated, the risks of following complications remain: recurrence of strictures, development of fistulas, incontinence, deformation of the penis, bleeding from the graft collection site, etc. For this reason, attempts to create new and improve existing methods of surgical treatment SU continue. For example, urethroplasty using an acellular patch from bovine pericardium or a combined material with the addition of buccal epithelial cells are effective, but methods that are not available for widespread use. The success rate of using these materials varies from 58.2 to 88.9%. The effectiveness of drug-coated balloon dilatation is 67.0–74.6%, and the method itself may become widespread in the near future.

Objective. Comparison of the effectiveness of surgical treatment methods for male US.

Methods. We selected full-text articles published on the resources “PubMed” and “Scientific Electronic Library” in Russian or English on December 10, 2023 using the keywords: “urethra”, “stricture”, “urethral stricture”, “treatment of urethral stricture”, «urethroplasty», «tissue engineering». The selection criteria were: the topic of research on US and their treatment, tissue engineering, and the duration of the research less than 8 years.

Results. Our study showed that due to the great effectiveness of single-stage and stage-by-stage urethroplasty, internal optical urethrotomy and, despite the existing risks of dysfunction and shape of the penis, these methods remain leading among other methods of surgical treatment of male US.